Editorial: An unhealthy care act

Updated 4:26 pm, Wednesday, March 22, 2017

Photo: STEPHEN CROWLEY

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President Donald Trump and Vice President Mike Pence meet with members of the Republican Study Committee to talk about the proposed American Health Care Act, in the Oval Office of the White House, in Washington, March 17, 2017. (Stephen Crowley/The New York Times) ORG XMIT: XNYT15 less

President Donald Trump and Vice President Mike Pence meet with members of the Republican Study Committee to talk about the proposed American Health Care Act, in the Oval Office of the White House, in ... more

Photo: STEPHEN CROWLEY

Editorial: An unhealthy care act

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The debate over health insurance in America comes down to this: Which will we be: a nation that provides all its citizens affordable health care or a country that views its people's health as an issue of Darwinian economic survival?

Forget the cherry-picked numbers and conclusions from all the reports and analyses. This is the crystal clear bottom line: Within a decade, 24 million fewer people will have health insurance if the Affordable Care Act — Obamacare — is replaced with House Speaker Paul Ryan's and President Donald Trump's American Health Care Act, according to the nonpartisan Congressional Budget Office.

Many, freed from the ACA's mandate to purchase health insurance, will opt not to get it. And who can blame them? Many won't be able to afford it. Some will have lost coverage through employers, who would no longer face penalties for failing to cover workers. Some will no longer have Obamacare subsidies to help them pay up-front for their health insurance. The Republican tax credit will be no help to them: You can't claim a tax credit for something you can't afford to buy in the first place.

The result: Just as we saw before Obamacare, millions of Americans will go without health care. Many will show up at emergency rooms and be unable to pay, even from those tax-free health savings accounts the Republican plan imagines them pouring their paychecks into. Their unpaid bills will be passed on to everyone else in the form of higher medical fees and insurance rates — a socialist outcome of the GOP's supposedly capitalistic answer to what's falsely labeled socialized medicine.

The benefit? Well, deficits would be trimmed by $337 billion through 2026, thanks to cuts in subsidies and Medicaid — which was expanded to provide health care to more low-income working people. Plus, there's a big tax cut for the wealthy, according to another nonpartisan panel, the Joint Committee on Taxation. Just two provisions — repeal of an investment tax increase and a surcharge on Medicare taxes — would cut taxes by about $274 billion through 2026 for people earning more than $200,000. For people with incomes over $1 million, it's a $144 billion tax cut.

All this leaves Republicans in Congress with a choice. Are party loyalty and ideological purity more important to those like Rep. Elise Stefanik, R-Willsboro, than the 64,400 of her constituents who, according to the Center for American Progress, will lose health coverage under this plan? Is Rep. John Faso, R-Kinderhook, comfortable with 65,800 people in his district losing health insurance? Will Mr. Faso keep his promise to vote against a bill that cuts Planned Parenthood funding, which ideologues insisted on tacking on to this bill?

This is ultimately about national priorities, and whether affordable access to health care for as many citizens as possible is one of them. It's about our elected representatives' priorities, too. Their votes will tell voters what — and who — they value most.

Note: The figures for the number of people at risk of losing health coverage in Rep. Elise Stefanik's and Rep. John Faso's districts originally used in this editorial have been corrected to reflect revised numbers from the Center for American Progress.